Collagenase Clostridium histolyticum Versus Needle Fasciotomy for Primary Metacarpophalangeal Dupuytren Contracture: Five-Year Results from a Randomized Controlled Trial.

研究概要

Eighty patients with a single-digit primary MCP joint contracture of ≥30° due to Dupuytren disease were randomized to receive either CCH (n=40) or PNF (n=40). The primary outcome was the reduction in MCP flexion contracture from baseline to 2 years. Secondary outcomes included complications, grip strength, patient-reported pain and hand function scores, treatment satisfaction, recurrence, and retreatments, assessed at multiple time points up to 5 years. Overall, the results revealed that both treatments were equally effective in reducing MCP flexion contracture, but the correction lasted longer in the CCH group. At 2 years, the mean difference in contracture reduction between groups was 12° in favor of CCH (p=0.026), but this difference was not statistically significant at 5 years. Recurrence was significantly higher in the PNF group. Patients treated with CCH experienced more transient complications but were more satisfied with their treatment over time. These findings suggest that while both treatments are effective, CCH provides a more durable correction with a lower retreatment rate.